L. Ron Hubbard was one of the most prolific writers in history, authoring more than 1100 books. He was also the founder of the Church of Scientology, arguably one of history’s most controversial quasi-religious organizations. Many of the tenets upon which Hubbard based his church are inarguably crackpot, but after reading Robert Whitaker’s latest offering one could easily conclude that at least one of Hubbard’s paranoid beliefs, that psychiatric drugs and the doctors who prescribe them are the tools of the Devil, may contain a grain of truth.
Whitaker’s book, Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs and the Astonishing Rise of Mental Illness in America, examines two related issues. The first is the astronomical increase over the last 60 years in the number of Americans who have been diagnosed with anxiety, depression and bipolar disorders, and schizophrenia. These conditions, now being diagnosed in as many as 850 adults and 250 children per day, often are so debilitating that sufferers are unable to hold a job and so become dependent on Social Security Disability Insurance (SSDI) to survive. The exploding number of mentally disabled being granted SSDI is threatening to bust the agency’s budget as early as 2016.
In 1955, around the time that the first psychotropic drugs like Thorazine were discovered, there were 355,000 people in the US under diagnosis for psychiatric conditions. Almost all were housed in state or county hospitals as was then standard practice. This number represented one in 468 Americans. By 1987, with the closing of most mental hospitals and the treatment of affective disorders well into the age of Lithium and Prozac, one in 186 Americans was on the mental patient rolls. Since then, in spite of the promises made by the psychiatric profession and Big Pharma that Selective Serotonen Reuptake Inhibitor (SSRI) drugs were the cure for America’s mental ills, the numbers are still going up.
The second issue Whitaker examines is the long term viability, and the unreported side effects, of these drugs. What happens when an affective disorder such as depression is treated using SSRIs? Spoiler alert: It’s not a cure. The drug may provide symptom relief in the short term, but a large and growing body of research is indicating that long term exposure to SSRIs leads to the drugs becoming less effective at altering the condition. Worse, the disruption of brain chemistry that the drugs induce may lead to impaired brain function, cognitive issues, even dementia. The drugs, it turns out, may control psychotic behavior, but do almost nothing to actually fix whatever is causing the disorder. In fact, doctors have little more understanding of how these brain afflictions do their damage today than they did in 1955.
Whitaker’s contentions, as one might expect, have been greeted with derision and hostility by most mainstream psychiatrists and their enablers in the pharmaceutical industry. The first group owes its parity with the rest of the medical community to SSRIs; psychiatrists, like other M.D.s, now had at their command a cabinet full of drugs that could provide instant relief for their suffering patients. The second group sells those drugs, to the tune of billions of dollars a year, and relies on them for the bulk of its profit margin.
Much of the book deals with patient anecdotes and references to the long term research on the use of SSRIs that is finally being done. The studies appear to show that, slow and laborious as it may be, conventional psychotherapy has reliably better outcomes than drug treatment for a wide range of affective disorders. Whitaker also gives readers an interesting history of society’s treatment of the mentally ill and an excellent layman’s explanation of how SSRIs do what they do.
Will the scales eventually tip against pharmapsychiatry? Or will the psychiatric establishment continue to turn its back on the evidence? If the latter scenario prevails, we may find ourselves living in a country where one in 76 citizens is collecting disability benefits that can easily add up to more than a million dollars each over his or her lifetime. If that is the road psychiatrists want to take us down, then maybe L. Ron Hubbard wasn’t so paranoid after all.
(A note on Scientology; read Going Clear, by Lawrence Wright, for more background on L. Ron Hubbard and his disturbing legacy.)